Otosclerosis-Richards BRITlsH 1229that the otosclerotic process was in some way directly responsible for the vestibular disturbances. Exactly how otosclerosis produces vestibular disturbances is not known, but from our knowledge of the histopathology of Meniere's disease and of otosclerosis, and by a careful analysis of the findings in the three cases recorded here, it is possible to make a few valid observations.It is known that otosclerotic disease can and commonly does extend to involve the cochlea (Ruedi, 1962) and that this can produce a perceptive loss of hearing. It is also known that otosclerosis may involve the semicircular canals (Seligman and Shambaugh, 1951) As the three cases had bilateral otosclerosis, it would seem to have been a fortunate "fluke " that in each instance we operated on the ear that was causing the attacks of vertigo. In all three patients, however, there were indications which pointed to one ear as being responsible for the vestibular disturbance; loss of balance was accompanied by a temporary worsening of the deafness on one side in Case 1 and by an increase in the intensity of the unilateral tinnitus in Cases 2 and 3. In addition, stapedectomy was always carried out on the ear that showed the greater degree of deafness and was therefore presumed to be the more severely affected by otosclerosis.
SummaryThree cases of otosclerosis are described in which the patients suffered from recurrent severe episodes of vertigo similar to those of Meniere's disease. Labyrinthine otosclerosis induces atrophic changes in the membranous labyrinth, and it is postulated that vertigo is due to sudden rupture of the latter. In each patient the vertigo ceased after stapedectomy, and this was probably due to a decompression effect on the labyrinth.My thanks are due to Mr. Ronald Macbeth and Mr. Gavin Livingstone, who allowed me access to cases under their care and who have given me unlimited help and encouragement in writing this paper; also to Professor Victor Lambert and Mr. Neville Young, who read the manuscript and made many useful suggestions.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.